2017 ICT4D Conference

Timed and Targeted Counseling (TTC) is a community-based health model integrating Maternal Newborn and Child Health, HIV and Nutrition, leveraging Behaviour Change Communication (BCC) messaging and a dialogue approach at household level in the first 1000 critical days of a child’s life. In 2013, World Vision customised a mobile solution (CommCare) for TTC. In 2014, 923 Community Health Workers (CHW) were trained to use the solution to conduct TTC activities, in collaboration with 26 health facilities. By 2016, 5,617 pregnant and lactating mothers including 4,940 children under two had been registered and followed up through the platform.

The outcomes of this innovation have included: an improved referral system with linkages to ambulance services, increased demand for services at the health facilities including deliveries, strengthened linkages between health facilities and community health workers, improved but informed planning and decision making by stakeholders in health, leveraging analysed data from CommCare and comparison with DHIS2 reports.

Some of the best practices included: stakeholder engagement at design, development and deployment, building local capacity for continued support and customisation of the application to a local context -including graphics and audios in the local language which accelerated solution acceptability. Some of the challenges included: Rapid change in mobile phone technology, poor network coverage, limited sources of power for charging phones and low literacy levels of community health workers.

This mHealth solution is now being scaled up in Hoima District with a target coverage of 589 CHW and in collaboration with 34 health facilities. In partnership with Ministry of Health and UNICEF, a road map has been drawn to not only integrate WV’s ttC CommCare solution with Uganda’s Community Health Management System (CHMIS) but also create a linkage with DHIS2. A close working relationship has also been maintained with MTN, a Mobile Network Operator, positive about supporting continuity of mHealth beyond the project end line.